Understanding the Hospice Final Rule

Fazzi has partnered with WellSky to present this free webinar.

The Centers for Medicare & Medicaid Services (CMS) have published the 2020 Hospice Final Rule, which includes a significant rebasing of hospice payment rates. Rates for higher acuity levels of care are increasing, while rates for routine home care are decreasing. The 2020 final rule also includes a complex new requirement for an addendum to election statements that must provide details as to the care, services, and drugs that will not be covered under the Medicare hospice benefit.

Implementation of the election addendum has been delayed until October 2020, but other provisions of the 2020 hospice final rule go into effect on October 1, 2019, so your time to prepare is very brief. The time to begin is now.

In this important 60-minute presentation, Catherine Dehlin, RN, BSN, CHPN, CHCM, Director of Hospice Services for Fazzi Associates will help you understand the new requirements, evaluate their impact on your processes, and create an action plan to succeed.

 Watch to learn:

  • How rebased payment rates for CHC, IRC, and GIP levels of care will affect your hospice
  • Why rebased payments may signal a new level of compliance scrutiny for hospices
  • The new requirements for an addendum to the hospice election statement


Fazzi’s Summary and Response to the OIG’s Hospice Reports

As you probably know, the US Department of Health and Hospitals Office of Inspector General (OIG) recently released a two-part report that reviewed hospice deficiencies across the nation from 2012-2016.

These reports are long, and there has been a great deal of media attention about them. We thought it would be useful to you to have an objective and digestible summary, and so we’re pleased to provide just that. In this paper from Catherine Dehlin, our Director of Hospice Services, you’ll find:

  • An objective summary of the two reports released by OIG.
  • CMS’ responses to the OIG’s recommendations to CMS.
  • Fazzi’s response.

Simplified PDGM Look-Up Tool Updated from Proposed Rule

We’re pleased to tell you that we’ve updated the Simplified PDGM Impact Look-Up Tool – a fast and easy way to see CMS’ updated projection of the financial impact of PDGM on your agency.

This Look-Up Tool accesses CMS’ Agency Level Impact projections updated with 2018 claims and 2020 proposed payment rates incorporated into the Proposed 2020 Home Health Payment Rule released July 18, 2019.


Home Health Compare Updated

The Home Health Compare results were updated on July 24, 2019.

For the Quality of Patient Care measures, 11 measures improved and 3 remained the same. Improvement in bed transfer and improvement in management of oral medications saw the most improvement of 0.9%. Multifactor fall risk assessment conducted, depression assessment conducted and influenza immunization received for current flu season saw no change. (Data Collection October 1, 2017 – September 30, 2018).

Acute care hospitalizations and urgent, unplanned care in the emergency room both stayed the same at 15.8% and 13.0%. (Data Collection January 1, 2017 – December 31, 2017).

The national average for the Quality of Patient Care Star Rating remained the same at 3.5 stars. The percentage of agencies with 2,3 and 4 stars declined and the rest increased.

HHCAHPS measures also updated and the national averages remain the same for 3 measures. Patient willingness to recommend and overall rating of care given by HHA’s care providers improved by 1%. The data collection period for these measures and the Star Ratings is January 1, 2018 – December 31, 2018.

To see where the 5 star agencies are located, visit our Home Health Compare page and use the drop down for Star Ratings at the agency level. You can also compare measures by state, by year, by release date, and the top 10 or top 20 percent.

Hospice Compare Updated

CMS has posted the quarterly Hospice Compare refresh of quality data on May 23, 2019. All quality measures improved since the last quarterly posting or stayed the same. Pain Assessment showed the most improvement, from 87.8% to 89.2%, followed by Composite Process Measure.

Updates to the family caregivers’ survey results showed seven measures remained the same. However, ‘Willing to recommend this hospice’ decreased by 1%.

Quality measure results are from data collected July 1, 2017 – June 30, 2018, and Hospice CAHPS® survey results reported July 1, 2016 to June 30, 2018.

View State Level Hospice Compare Charts

Long Time Industry Leader Shares Insights about Interim Leadership

Our industry is experiencing a high number of senior level retirements and other types of vacancies, and it’s becoming harder to find qualified people to fill these positions. Therefore, we’re getting a lot of questions about Interim Leadership, and so we thought we’d share with you this Q+A with long time industry leader, Eileen Freitag, who directs Fazzi’s Interim Leadership program.

Q: What types of situations cause agencies to consider engaging an Interim Leader?
A: We’ve seen many different scenarios including short term leave of absences; maternity leaves; retirements and other vacancies when there is no internal candidate to fill the job; retirements and other vacancies when none of the internal candidates are the right fit; and situations when the agency is underperforming and a key manager leaves either voluntarily or involuntarily.

Q: What positions has Fazzi filled in the past?
A: We have placed Interim Leaders in these positions: CEO, COO, Clinical Director, Director of Patient Services, Director of Quality, Clinical Manager and Billing Manager.

Q: Can you share specific examples of how agencies have utilized Fazzi’s Interim Leaders? 
A: In one agency, the CEO left on short notice for medical reasons while in the midst of software selection and negotiation with a therapy vendor. Our Interim CEO steered both projects to successful conclusion, and additionally, the agency experienced increases in staff retention and productivity.

A: We’ve had many situations in which agencies’ performance was in decline at the time of the CEO’s departure. In these instances, our Interim Leaders have conducted assessments and developed turnaround plans to fix problems and stabilize the organization so that the new incoming Leader starts with a clean slate. In many of these instances the agency found it easier to find permanent candidates for a stable organization instead of needing to find someone with turnaround skills.

A: In other scenarios, agencies have engaged Fazzi’s Interim Leaders to mentor a new executive – especially if they’ve come from outside of home health or hospice.

Q: Who are Fazzi’s Interim Leaders?
A: Our Interim Leaders are people who have retired early, have had successful track records in home health and/or hospice and still love the field and want the opportunity to take shorter term assignments (up to one year). They love the adventure of coming into an agency, quickly assessing the needs, and developing and executing a plan for results. They understand that often times, staff have been through a lot of stress when they’ve lost a leader that they knew and respected. Our Interim Leaders are skilled at balancing the need for sensitivity to this as well as the need to make changes to improve the performance of the agency.

Q: What is the process of getting an Interim Leader placed? 
A: We start with an in depth discussion about the client’s needs; i.e. the duties of the position, specific challenges the agency is facing, the characteristics of the agency and specific qualities and/or skills the client wants this person to have. From there we will send a potential candidate for the client to review. Our goal is to find someone that has the skills needed with the least possible travel time and expense.

If you’d like to speak with Eileen further about Fazzi’s Interim Leadership program, please contact us.

More Than PDGM: Home Health’s Top Legal and Compliance Issues Now

Thursday, June 20  |  12:00pm-1:00pm CT
Register Now

Since Fazzi Associates is now a member of the WellSky team, we’re able to bring you even more important industry resources and insights. Today, we’re pleased to present this complimentary webinar to be hosted by WellSky on June 20.

Although most home health providers are intensely focused on PDGM, it is far from being the only regulatory and legal issue that is impacting compliance today. Issues ranging from the ongoing Brookdale litigation to the Department of Labor’s notice of proposed rulemaking that would make more than a million more American workers eligible for overtime will have huge impacts on the home health industry.

While you’ve got your eye on PDGM, don’t overlook the big picture of compliance risk!

Join renowned home health attorney Robert W. Markette of Hall, Render, Killian, Heath & Lyman, P.C. for an exclusive webinar that will prepare you and your team for key changes in compliance that you may have missed while busily preparing for PDGM.

Attend and learn:

  • The risks of sudden practices shifts in 2020
  • What the Supreme Court decision to decline the Brookdale case means for home health
  • How the #metoo movement is leading to renewed focus on sexual harassment and what that means for employers
  • The Department of Labor’s salary notice of proposed rulemaking and what it means for professional exemptions

This is the guidance your agency needs right now. Don’t miss it!

Register Now

About the Presenter
Robert W. Markette, Jr., CHC, HCS-C of Hall, Render, Killian, Heath & Lyman, P.C.

Robert has focused his practice on representing home health, hospice, private duty and DME providers in all aspects of their operations. Robert has developed a reputation for understanding the operational, compliance and legal/regulatory issues facing homecare providers. He serves on both the Board of Medical Specialty Coding and Compliance and the Board of the Association for Home Care Compliance. Robert drafted the Second Edition of the Homecare Administrator’s Field Guide and the Home Health Patient Rights Policy and Procedure Manual. He has been awarded the HCS-C credential signifying his knowledge and experience in home care compliance and is also certified in health care compliance by the Health Care Compliance Board. Robert is widely recognized for his expertise in this space and is a frequent speaker on home health, hospice and private duty matters across the country.

Home Health Compare Quality Charts Updated

The Home Health Compare results were updated on May 17, 2019.

For the Quality of Patient Care measures, 11 measures improved, 1 worsened, and 2 remained the same. As with last quarter, improvement in bed transfer saw the most improvement of 1%. Improvement in management of oral medications improved by 0.9%. Multifactor fall risk assessment conducted saw no change and Depression assessment conducted worsened by 0.1%. (Data Collection July 1, 2017 – June 30, 2018).

Acute care hospitalizations and Urgent, unplanned care in the emergency room both stayed the same at 15.8% and 13.0%. (Data Collection January 1, 2017 – December 31, 2017).

The national average for the Quality of Patient Care Star Rating remained at 3.5 stars. The percentage of agencies with 2.5 and 3.5 stars declined, and the percent of agencies with 1,1.5 and 5 stars increased.

HHCAHPS measures also updated and the national averages remain the same for 4 measures. Patient willingness to recommend worsened by 1%. The data collection period for these measures and the Star Ratings is October 1, 2017 – September 30, 2018.

To see where the 5 star agencies are located, visit our Home Health Compare page and use the drop down for Star Ratings at the agency level. You can also compare measures by state, by year, by release date, and the top 10 or top 20 percent.

Proposed Hospice Rule Summarized

On Friday, April 19, the Federal Register posted the public inspection copy of the FY2020 Hospice Wage Index proposed rule. Comments on the proposal are due to CMS by June 18, 2019.

Fazzi is pleased to provide you with a comprehensive summary of the proposed rule prepared by Catherine Dehlin, Fazzi’s Director of Hospice Services.

Please complete the form to download your copy.

OASIS-D1: What You Need to Know

Just this week CMS announced that OASIS-D1 is available for review. The revised OASIS data set will take effect on January 1, 2020 and includes updates that will support the Patient-Driven Groupings Model (PDGM).

Highlights include:

Two existing items are added to the Follow-Up time point for data collection. This includes:

  • M1033 Risk for Hospitalization
  • M1800 Grooming

In addition, data collection at certain time points for 23 existing OASIS items is optional.

Click here to find a memorandum containing details about the changes to OASIS effective January 1, 2020.

Get access to our entire suite of OASIS online learning and testing programs with the Fazzi Learning Center. This includes OASIS-D1 updates as well as training on the key PDGM OASIS items.

Learn More About OASIS Education